HAPPILY EVER AFTER FOR THE PRINCE WITH A KIDNEY TRANSPLANT

A fascinating story has just been brought to light by the local Swedish business newspaper, Dagens industri. The Swedish royal family includes an organ transplant recipient! Prince Daniel, the husband of Crown Princess Victoria, acknowledged undergoing a live donor kidney transplant in 2009 as treatment for congenital kidney disease just three months following his engagement to the Princess. His father was his donor. While other medical details were not shared, his photo suggests that he is doing quite well. And he has met the basic American measures of successful transplantation by surviving more than three years with the transplant. It appears that he is now six years out from the transplant and presumably still counting. And happily living the life of a royal.

The matter-of-fact way the issue seems to have been approached by the royal family into which he married, and by the Swedish population who appears to adore the now married couple, is extraordinary. This is hardly the first time that transplantation has touched the life of a person in the public eye. It is also not an unusual illustration of the magnificent way transplantation permits rehabilitation to a full level of function, whether royal (Prince Daniel), presidential (Ferdinand Marcos), athletic (Alonzo Mourning), musical (Charity Sunshine Tillemann-Dick), thespian (Larry Hagman), retired (Dick Cheney), or more ordinary (half a million transplants). Indeed, it is just another example of the full potential that awaits those in need of organ transplants. Meaningful, high quality life is widely achievable.

While some might be inclined to conclude that the transplant was performed simply because Daniel was soon to be a Prince, the more appropriate observation is that his own parent was the organ’s source. No other connection than family was required. And such a source is just as likely to be available to any of us, as to a Prince-to-be.

For the transplant to continue functioning as well as it appears to be, the Prince must be taking immunosuppressive medications to prevent rejection of that kidney. Years ago, there were few choices about which medications to use. Often, undesirable cosmetic consequences of those medications such as a very rounded face or exuberant facial hair growth were readily apparent. Today, however, such a broad choice of drugs is available that those undesirable outcomes are quite rare. They do not appear to be complicating Prince Daniel’s life.

The take home message from this “ordinary” royal news is that transplantation has evolved into a standard therapy with excellent results that is widely available in developed countries served by mature medical and social infrastructures. The limitations to even broader access include the woefully inadequate availability of organs (overcome through live kidney donation in Prince Daniel’s case) and the relatively high costs of surgery (in the first year) and maintenance medications (lifelong).